Prognostic Value of Novel Biomarkers on Adverse Renal Outcomes in High-Risk Cardiac Surgery Patients

Adult patients were included in the study if they were scheduled for elective open chest cavity cardiac surgeries, with or without the use of cardiopulmonary bypass (CPB). Inclusion criteria required that patients undergoing surgery with CPB must have at least one AKI risk factor, whereas those undergoing surgery without CPB needed to have at least two AKI risk factors.

The AKI risk factors were as follows:

• age >70 years;

• 30 < estimated glomerular filtration rate (eGFR) <60 mL·min-1·1.73 m-2;

• diabetes mellitus, proteinuria;

• a history of congestive heart failure within the previous year;

• a left ventricular ejection fraction of 40% or lower;

• prior cardiac surgery;

• combined coronary artery bypass/valve procedure;

• urgent procedure;

• preoperative intra-aortic balloon pump.

Exclusion criteria:

• pre-existing chronic kidney disease (preoperative estimated glomerular filtrationrate [eGFR] < 30 mL/min/1.73 m2);

• previous RRT before cardiac surgery;

• present AKI at screening;

• a history of kidney transplant or other kidney diseases;

• known pregnancy;

• multiple operation during the hospital stay;

• being in a moribund state (with an anticipated likelihood of death within 48 hours).